Thursday, April 11, 2013

wo pharmaceutical companies that are among the biggest payers of fees to doctors reduced such spending last year by double-digit percentages, as greater transparency sheds light on the hundreds of millions of dollars the industry pays physicians for marketing and research efforts. Reduced spending on dinners and other events where drug makers pay expert doctors to give presentations to peers about certain drugs and diseases became a big source of the declines for Pfizer Inc. (PFE) and GlaxoSmithKline PLC (GSK). Also, layoffs of pharmaceutical-sales representatives and patent expirations for big-selling drugs have resulted in fewer sales calls on doctors, and thus fewer free lunches provided to physicians' offices. The declines, though, weren't universal. Some drug makers increased payments, while others implemented new payment-reporting systems that made year-over-year comparisons difficult. But recently released numbers suggest some companies have used the more detailed data they have collected about physician payments to guide resource allocations, and to make cuts when necessary. "It is possible the trend we've seen for a few years toward increasing focus on payments will continue, and both providers and companies will relook at some of these financial relationships," said Allan Coukell, deputy director of medical programs for the Pew Charitable Trusts, which has supported greater transparency around physician payments. Some doctors say industry influence has waned in certain areas, partly due to limitations by medical schools on what faculty and students can accept from companies. Some 44 medical schools ban or severely restrict faculty participation in pharmaceutical speakers' bureaus, according to a report this week from the American Medical Student Association. Also, commercial support for continuing medical education--which doctors need to maintain their licenses--has trended downward. "There are many more doctors and doctors in training over the course of the last five or 10 years who have been in environments with less drug-industry involvement than comparable students might have had a decade earlier," said Robert Steinbrook, a physician and adjunct professor of internal medicine at Yale School of Medicine, who has written articles about physicians' interaction with industry. Some doctors are leery of the disclosures, fearing inaccurate or misleading data will be posted. A recent survey of more than 1,000 doctors by information-technology companies MMIS Inc. and Healthcare Data Solutions found 63% of respondents were concerned about public disclosure of payments, and 21% said they would sever their relationships with manufacturers that report inaccurate information. The firms sell software and services designed to help companies comply with disclosure rules. Industry-physician relationships have come under increased scrutiny, with critics saying payments can improperly influence physicians' prescribing patterns. Drug makers say the payments are necessary to compensate doctors who advise them, assist in drug research and clinical trials, and help educate other doctors about drugs and diseases. Pfizer, Glaxo and others have begun posting reports of payments to individual doctors on their websites over the past few years, either voluntarily or in compliance with the terms of settlements of government investigations of drug-marketing practices. Transparency proponents say the disclosures allow patients to know whether their doctors receive money from makers of the drugs they prescribe. They also hope the transparency will deter improper relationships. Pfizer's payments to U.S. health-care professionals totaled $173.2 million in 2012, down 11% from 2011, according to data the company posted online in March. A majority of the payments were related to clinical research, which stayed roughly flat year over year. But Pfizer reduced spending on meals for doctors by about 40% because the company's sales force is smaller and is conducting more online, "virtual" meetings between doctors and company representatives, said spokeswoman Sharon Castillo. Pfizer also cut by more than 60% its spending on expert-led forums, which include events where company-paid doctors discuss Pfizer drugs or certain diseases. The company funded 1,539 health-care professionals speaking to peers at forums in 2012, down from 3,569 in 2011. Average payments per professional declined to $5,380 from $6,110. Pfizer's drop in speaker-program spending was partly related to losses of exclusivity for certain drugs. Pfizer pulled back on promotional spending on cholesterol-lowering drug Lipitor after the late-2011 loss of U.S. exclusivity triggered low-cost generic competition. The company also attributed the decline in spending on speaker programs to "more efficient ways to deliver educational materials and evolving approaches to meet physicians' information needs." GlaxoSmithKline reduced overall payments to U.S. physicians by 20% for 2012, to $97.1 million. The comparison is partially skewed because Glaxo changed criteria for what it reports in the fourth quarter 2012, but spokeswoman Mary Anne Rhyne said payments for items such as speaker programs have declined, regardless of how they are tallied. Each year, Glaxo re-evaluates its need to fund speaker programs, and the need in recent years hasn't been as great, Ms. Rhyne said. "The trend on spending has been downward at GSK but we continue to believe speaker programs are a good method to facilitate peer-to-peer education on topics of importance for the health of patients," Ms. Rhyne said. Teva Pharmaceutical Industries Ltd.'s (TEVA, TEVA.TV) Cephalon unit also reduced expenditures on health-care professionals in 2012, by nearly 11% to $28.1 million, said spokeswoman Denise Bradley. The payment figures aren't always comparable among companies because some use different criteria. For instance, some companies report totals for clinical-research payments, while others don't. AstraZeneca PLC's (AZN, AZN.LN) payments for 2012 inched up nearly 2% to $30.6 million, a figure that includes consulting fees, speaker fees and meals, but not clinical research. Certain Johnson & Johnson (JNJ) pharmaceutical divisions increased payments to U.S. physicians by 15% to $27 million for 2012, which spokesman Mark Wolfe attributed to increased consulting in support of J&J's scientific educational activities. Merck & Co. (MRK) paid $225 million to U.S. health-care professionals in 2012, some 80% of which was for clinical research while the rest included speaking, consulting, grants and other expenses, said spokeswoman Kelley Dougherty. There is no meaningful 2011 comparison, she said, because 2012 was the first year Merck included post-merger activities for products from Merck's acquisitions of Schering-Plough and Inspire Pharmaceuticals, as well as clinical-research activities. Merck's reported total for 2011 under the more limited criteria was $27 million. Write to Peter Loftus at peter.loftus@dowjones.com

Subscribe To

Recent Posts

PharmaTweets

PharmaTweets

Email Subscriptions powered by FeedBlitz

Call me Jack

The term "PR" means something completely different to a medical doctor!
"We are all born ignorant, but one must work hard to remain stupid." -Benjamin Franklin.
"It takes a wise doctor to know when not to prescribe."
- Gracian.